In the course of a decompression of the dura of the middle cranial fossa for a localized pachymeningitis complicating a chronic mastoid infection, a bone fragment was accidentally broken off the inner table, and a triangular tear was made through the dura.
Fortunately, this happened at the completion of the operation, after a wide posterior incision had been made, leaving the posterior segment of the temporal muscle exposed. Clear spinal fluid pulsated freely through the accidental opening, and as it was promptly recognized, no gauze or any instruments came in contact with the perforation in the infected field. A segment of temporal muscle was dissected free, but was left attached above. This viable muscle was firmly held over the dural opening, by finger pressure for three minutes, and the overlying periosteum and soft tissue were then tightly sutured.
The wound healed by primary intention, without suppuration, and
DIXON OJ. REPAIR OF AN INJURY TO THE DURA OF THE MIDDLE CRANIAL FOSSA WITH VIABLE MUSCLE. Arch Otolaryngol. 1935;22(2):187. doi:10.1001/archotol.1935.00640030200009